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Doctors in China Lead Race to Treat Cancer by Editing Genes
- yohann305 9y agoCancer treatment should not be viewed as a race. The world needs to team up. We all win when someone finds a new cure.
- deleted 9y ago[deleted]
- loceng 9y agoRaces can be healthy - non-aggressive in nature - like racing for prestige; you can race other people on your own team too! Sharing information of course is important in case important discoveries are kept quiet by a corporation with ulterior motive.
- _rpd 9y agoI would go even further and say that competition is vital to innovation. Without it, too few are willing to take risks and progress stagnates.
- IntronExon 9y agoYou don’t think the prospect of treating cancer is insufficient motivation, there needs to be some poxy “race” as well? You’re selling both the motivations of researchers, and the practical rewards of that research short.
- _rpd 9y agoIt is less about individuals and more about the organizations and funding systems that accumulate over time. Any research worth their salt can tell you stories of opportunities missed due to bureaucratic constraints.
- jamesrcole 9y agoWhat is the problem with there being a race element as well? Anyway, I don't see how it's avoidable. There'll be kudos, prestige, more grant money, etc for people who make advances, so there's going to be a race element to it as well.
- IntronExon 9y agoI would go even further and say that competition is vital to innovation. Without it, too few are willing to take risks and progress stagnates. That’s what I responded to. Vital. Few willing to take risks. To fight cancer!
- jamesrcole 9y agoI don't know about "vital" but I do think competition is intrinsic to it. They want to make a contribution to addressing this important problem, which means they want to beat others to it. It adds impetus. Also, the motivations I mentioned apply, to some extent, to the funding bodies.
- IntronExon 9y agoEvery one of those individuals and their bosses, and fundraisers all are or will be affected by cancer, either personally or in their close relationships. There is a reason why cancer research is so well funded, both privately and through charity. Ideology isn’t required here.
- jamesrcole 9y agoWhy are you equating races to be first with ideology? I do not see any connection at all. Also, I think the reasons you give are exactly why you should want there to be races involved, because they will help speed progress. You said they weren't vital to doing the research, and I concede that, but you haven't argued that progress will happen at the same or a faster pace without competition.
- loceng 9y agoThe motivation comes from seeing or experience loved ones you know suffering, up to dying, from cancer - and perhaps from seeing the barbaric feeling treatments that exist for cancer currently. Edit: I suppose having races is positive hype-marketing machine, hopefully playfully tapping into our dopamine reward systems.
- IntronExon 9y agoExactly, we’ve all been affected in some way by cancer, no need for a race against anything other than cancer itself.
- loceng 9y agoWell put.
- daxorid 9y ago> treating cancer is insufficient motivation The fact that the US unnecessarily hamstrings cancer research over dubious moral qualms clearly indicates that yes, treating cancer is itself insufficient motivation in this country.
- IntronExon 9y agoWhat dubious moral qualms are you referring to?
- vkou 9y agoThings like requiring drug companies to conclusively prove that their treatments actually work and don't kill people when used as intended.
- IntronExon 9y agoHow monstrous! I too yearn for the halcyon days of thalidomide.
- JumpCrisscross 9y ago> You’re selling both the motivations of researchers, and the practical rewards of that research short You're selling the evidence short [1][2]. Commercial, political and basic research opportunities compete for resources from the same well. Competition increases the tap to basic research. That, in turn, increases output. (Up to a point [3].) [1] http://www.jstor.org/stable/2094753?seq=1#page_scan_tab_contents http://www.jstor.org/stable/2094753?seq=1#page_scan_tab_cont... [2] http://www.mba.intercol.edu/Entrepreneurship/UT%20Computer%20Science%20Course/Simple_Economics_Basic_Research.pdf http://www.mba.intercol.edu/Entrepreneurship/UT%20Computer%2... [3] http://eprints.rclis.org/23682/1/Current-socio-published-non-Sage-format.pdf http://eprints.rclis.org/23682/1/Current-socio-published-non...
- realitygrill 9y agoAs for the motivations of researchers: If any student comes to me and says he wants to be useful to mankind and go into research to alleviate human suffering, I advise him to go into charity instead. Research wants real egotists who seek their own pleasure and satisfaction, but find it in solving the puzzles of nature. --Albert Szent-Györgyi My [indefensible] impression is that altruistic culture is a strong part of the reason why the quality of biomedical researchers is so poor, and cancer research funding is so often near-fraudulent.
- musage 9y ago"Research" doesn't want anything, and if that guy wants that, he should make a good case for it. Personally, I find this has the priorities much more in line: > Our time is distinguished by wonderful achievements in the fields of scientific understanding and the technical application of those insights. Who would not be cheered by this? But let us not forget that human knowledge and skills alone cannot lead humanity to a happy and dignified life. Humanity has every reason to place the proclaimers of high moral standards and values above the discoverers of objective truth. What humanity owes to personalities like Buddha, Moses, and Jesus ranks for me higher than all the achievements of the enquiring and constructive mind. What these blessed men have given us we must guard and try to keep alive with all our strength if humanity is not to lose its dignity, the security of its existence, and its joy in living. -- Albert Einstein > My [indefensible] impression is that altruistic culture is a strong part of the reason why the quality of biomedical researchers is so poor, and cancer research funding is so often near-fraudulent. Indefensible means you're not prepared to offer any elaboration at all? What's the line of reasoning here? Nevermind evidence, but you have to have more than just the claim. And what is fraudulent funding? If all people involved were "too altruistic", would anyone ever make sloppy research to grab funding, around a subject involving so much suffering?
- tooltalk 9y agoSure, altruistic motives and races aren't necessarily mutually exclusive. Their ends goals are to find cure for cancer, but researchers should be able to use different, competing approaches to find the best solution to the problem.
- 0xJRS 9y agoCoopetition
- xiphias 9y agoThe world is teamed up more than ever: as soon as there was result it was published on internet. The ongoing study was published on a U.S. website. The lots of interesting trials that are going on is the opposite of what was happening in the last 30 years when it took many years for a drug company to publish any result of any interesting test that it had made.
- jlebrech 9y agoif you team up you look for solutions in the same places.
- throwawaymanbot 9y agoWhy worry about a word in the title, and why worry if it is a race. Someone always has to lose a race. Right now its cancer patients.
- melling 9y ago"A lab at a biotech company two hours away by bullet train extracts T cells from the blood." Two hours away by bullet train... Something you don't hear in the US. A 21st century infrastructure paying dividends.
- refurb 9y agoYes, because the US doesn't have any infrastructure that could support the rapid transport of lab samples.
- seanmcdirmid 9y agoThis. Related, China has a huge problem with volunteer donor organ transplants because they have no easy way to get it from the donor to donee in time (they would have to take on a train or fly it in economy with china’s famous aircraft delays, no helicopters or air courier services). Part of the reason why predictable condemned prisoner donations were so important... Now that they can’t rely on condemned prisoners anymore (at least they’ve promised the ban is for real this time), bullet train infrastructure is quite useful.
- thinkloop 9y agoMore on this in case anyone was interested: https://optn.transplant.hrsa.gov/resources/ethics/the-ethics-of-organ-donation-from-condemned-prisoners/ https://optn.transplant.hrsa.gov/resources/ethics/the-ethics... > prisoners be given the option of donating organs upon their death > another suggests that condemned prisoners be offered the option of trading a kidney or their bone marrow in exchange for a commuted sentence of life in prison without parole > Application of the death penalty is spasmodic and seemingly discriminatorily applied, which would suggest that these types of proposals would be coercive to particular classes of individuals--minorities and the poor. There are so many things that would be sensible policy (i.e. using organs of dead people) were it not for the surrounding hazards they create: incentive to give death penalties, wealthy people abusing, greater chance of weak defenses, etc. If we could solve the slippery slope problem, so may things would be possible.
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- refurb 9y agoMy only thought is that there is more to advancing the science than just who starts the first trial.
- rsbartram 9y agoEditing genes to cure cancer is great but we must also be forward thinking for what else will gene editing want to be used for, good and bad, and implement major controls so gene editing doesn't become a black market or underground application for evil. https://latechnews.org/uci-school-of-biological-sciences-deans-distinguished-lecture/ https://latechnews.org/uci-school-of-biological-sciences-dea... Charles Dunlop, founder of Ambry Genetics, will sit down with Dean Frank M. LaFerla for an intimate conversation about his colorful background, the evolution of genetic testing, and how Ambry Genetics grew from an office above a Harley-Davidson store to being acquired for nearly $1 billion.
- jostmey 9y agoIt's fun to heap criticism on China's research. There's too many fraudulent results, as a culture they don't value out of the box thinking, ect. That kind of thinking hurts us, not China. But as a researcher in the US working with data collected from Human samples, I will attest that the bottleneck to progress are the regulations. What we don't want are regulations that make it impossible to get the research started. What we want are regulations that ensure that new drugs and treatments sold on the markert actually work. This is exactly the opposite of the situation in the US today.
- amelius 9y agoCan you give some examples of regulations that are counter-productive, where their suspension presents no ethical challenge?
- rconti 9y agoIf even one person could die, there's ALWAYS an ethical challenge. Unfortunately, we disregard the ethical challenge in not trying.
- JamesBarney 9y agoThe trick is in "no ethical challenge". Why should the answer to the number of years or lives we sacrifice to cure Alzheimer's be 0?
- frozenport 9y agoThe article gives a good one. The patients in the article are going to die in months, why not try something?
- jostmey 9y agoTook ~2 years to get approval to be able to seek patient permission to have their discarded tissue sequenced. Now that we are forming questions with the results, I hope it won't take another 2 years to get approval to run new tests :-/ In, retrospect is it even worth it?
- ramblenode 9y ago
- perseusprime11 9y agoIt will be interesting to see how long it takes to cure this disease given the incentive of pharmacy companies making money on drugs.
- lopmotr 9y agoI don't think that's really an obstacle. New biotech companies form all the time to try and bring new tech to market. They get zero money from any existing drugs.
- DigitalSea 9y agoI think maybe 15-20 years ago this might have been a valid concern, but technology has allowed the advancement and creation of biomedicine. Make no mistake, even if they find a cure for specific types of cancer, pharmaceutical companies branching out into biomedicine will still make money from cancer and other diseases. Editing genes are one thing, but it's going to take a long time before cancer is ever completely eradicated. What an exciting time to be alive.
- simpleAdam 9y agothis reads like propaganda. sorry
- deleted 9y ago[deleted]
- vadimberman 9y agoNow with numbers and without comments from European anthropologists in Singapore: https://qz.com/1185488/chinese-scientists-used-crispr-gene-editing-on-86-human-patients/ https://qz.com/1185488/chinese-scientists-used-crispr-gene-e... . Spoiler alert: I wouldn't want any other country to follow the example of China. Sometimes, human lives are more important than KPIs and being first... Some interesting parts: > The Chinese ministry of health has to approve all gene-therapy clinical trials in China, but these regulations appear relatively relaxed. According to the WSJ, at Hangzhou Cancer Hospital, for example, a proposal to test a cancer treatment that modifies patients’ immune cells was approved in a single afternoon. One member of the hospital’s approval committee told the WSJ that she did not really understand the science laid out for her in a 100-page document, but was told that the side effects were mild. This was enough for her to give it the go-ahead. ... > China is taking the lead in the global race to perfect gene therapies. > Scientists have genetically engineered the cells of at least 86 cancer and HIV patients in the country using Crispr-Cas9 technology since 2015, the Wall Street Journal reports (paywall). Although no formal scientific papers have been written about these experiments, doctors told journalists at the WSJ that some patients have improved. There have also been least 15 deaths, seven of which were in one trial. 86 (!!!) patients.
- rjett 9y agoI'm not a cellular biologist or a doctor of any kind, but I consider myself a reasonably smart person. Reading the book Tripping Over the Truth by Travis Christofferson and tracking the work of Thomas Seyfried and others, it makes me think that a lot of the discussion in the battle for curing cancer is chasing a false paradigm: that cancer is a disease of genetics and if we could understand and edit the genome, we could cure the disease. The case for the Metabolic theory of cancer as laid out by Seyfried is quite compelling and if true, the implications for treatment from a patient standpoint seem to me much more preferential than the current combination chemotherapies which are only getting more and more expensive and only marginally more efficacious. Work on this front is only in its infancy, but my hope is that more people become aware, more funding directed towards metabolic therapy trials, and one day it could at least be incorporated into the standard of care.
- josu 9y agoIf you read the article you'd realize that it doesn't talk about modifying the patients DNA to cure the cancer, the are just editing T cells so they will attack the cancer. Metabolic therapy seems promising, but I don't think it will ever be as effective as other forms of therapy that we will come up with. >The treatment Wu is testing involves taking a sample of blood from each patient. A lab at a biotech company two hours away by bullet train extracts T cells from the blood. Scientists then use CRISPR to knock out a gene in the T cells known as PD-1. This engineering feat modifies the T cells so that they zero in on and attack the cancer cells, once they're infused back into each patient.
- rjett 9y agoI realize the article is discussing a form of immunotherapy, but I think immunotherapy is also in its infancy, and given the nature of cancer cells and the heterogeneity of its own genetic makeup, immunotherapy still seems like a very blunt weapon in the war on cancer. For a patient who has already been beaten down by rounds of chemo and radiation, it offers a last ditch hope for survival, but its still laden with risks and adverse outcomes. On the contrast, metabolic treatment is tough from the standpoint that it requires strict discipline by the patient to adhere to the protocol, but the "side effects" may actually enhance overall health at the cellular level. It's a treatment that at the very least could be melded with the current standard of care to achieve better outcomes, and yet there's very little awareness of it, possibly because there's not a lot of money in it for hospital systems.
- lawrenceyan 9y agoThere are existing immunotherapies that already target PD-1 receptors, which is what the article’s treatment of T cells is doing ex vivo. Pembrolizumab, for example, is an FDA approved first line therapy for all cancers expressing high microsatellite instability or mismatch repair which is a highly conserved attribute among people who smoke and drink, one of the main reasons for why China has such an abnormal amount of cancer in their population in addition to additional extraneous factors like rampant pollution, due to their extreme carcinogenic effects. This article seems to imply that the risk aversion taken by the FDA is resulting in lives not being saved, but is incorrect in it’s assertions. Especially since the utilization of CRISPR is still at a stage of, what is in my opinion, the creation of an unnacceptable mutational burden, immunotherapies like pembrolizumab which work to inhibit receptors through the usage of monoclonal antibodies are the best forms of treatment. In no way do I doubt the potential of gene editing and the good it can do, however, when I say this. The point is though, is that when you rush things too quickly, it inevitably ends up hurting the patient.
- Paraesthetic 9y agoAmazing what you can do when your medical community lacks any ethics or rules.
- RestlessMind 9y agoUS has become too risk averse, so every accident leads to yet another regulation. There was a discussion on HN last year, which discussed how death rates on public construction projects have fallen to zero (unfortunately can't find a link to that). On the one hand, thats a great news and I certainly don't want to be the person to lose my life due to lax regulations. But on the other hand, we should also consider the lost opportunity due to progress not made either due to regulatory obstacles (like biomedical research for cancer cure discussed here) or insufficient public funds (due to overspending on public works to minimize fatalities). Ultimately, the question boils down to how much dollar value we as a society want to put on human life. A very high value will have obvious apparent benefits but lots of non-obvious costs.
- fny 9y agoIt also depends heavily on whether you believe people who work in construction (i.e. blue collar workers) are an currency expendable on behalf of people who have cushy low risk jobs. I’d be inclined to agree with you if we all had the same chance of risking our lives for the greater good and we could mutually agree on what the odds should be, but I feel like that’s why we’be come to the conclusion that it’s probably best if people didn’t die on a construction site for the same of innovation. (Also, I’d bet negligence is probably a more proper cause.) Clinical trials for cancer are less fraught with the ethical problems of the construction worker since presumably the patient is that desperate for a cure, but we have general standards for these things like IRBs, protocols, and physicians trained to “do no harm” just to make sure the final product is safe and won’t guarantee a sooner death. Also, while we may be at a disadvantage since we can’t just throw money at the problem, we’re still making remarkable progress: https://ghr.nlm.nih.gov/primer/therapy/availability https://ghr.nlm.nih.gov/primer/therapy/availability